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Late diagnosed congenital dislocation of the hip
1University of Oslo, Sophies Minde Orthopedic Hospital, Norway.
Insights
Late-detected developmental dysplasia of the hip (CDH) affects 2.4 per 1,000 live births in Norway. Girls and left hip involvement are more common, suggesting potential differences in causes compared to early-diagnosed cases.
Area of Science:
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip (CDH)
- Epidemiology
Background:
- Developmental Dysplasia of the Hip (CDH) is a common congenital disorder.
- Late detection of CDH can lead to more complex treatment and poorer outcomes.
- Understanding the incidence and characteristics of late-diagnosed CDH is crucial for public health initiatives.
Purpose of the Study:
- To determine the incidence of late-detected developmental dysplasia of the hip (CDH).
- To analyze the demographic and clinical characteristics of children diagnosed with late CDH.
- To explore potential etiological differences between neonatally stable hips diagnosed later and neonatally detected CDH.
Main Methods:
- Retrospective cohort study analyzing live-born infants from five counties in southeast Norway (1975-1979).
- Inclusion criteria: infants treated for late-detected CDH.
- Data collection included incidence rates, hip involvement (dislocation, subluxation, dysplasia), sex, affected side, and delivery position.
Main Results:
- An incidence of 2.4 per 1,000 live births for late-detected CDH was observed.
- Acetabular dysplasia without dislocation was the most common diagnosis (1.4 per 1,000).
- Eighty-six percent of affected children were girls, 48% had left hip involvement, and only 6.5% were breech deliveries.
Conclusions:
- The findings highlight a significant incidence of late-detected CDH, particularly acetabular dysplasia.
- The high proportion of girls and left hip involvement, along with low breech presentation rates, suggests a distinct etiology for late-diagnosed CDH compared to early-detected cases.
- Further research into risk factors and preventive strategies for late-detected CDH is warranted.
Abstract:
During the years 1975 to 1979, 82,574 children from five counties in southeast Norway were live-born, 197 of whom were treated for late detected CDH, for an incidence of 2.4 per 1,000 live births, i.e., 0.4 promille dislocation, 0.6 promille subluxation, and 1.4 promille dysplasia of the acetabulum without dislocation. All the hips had been found stable at birth. Eighty-six percent were girls, and the left hip was affected in 48 percent, the right hip in 31 perent, and both hips in 21 percent. Only 6.5 percent were delivered in the breech position. This and the stability found neonatally may indicate an etiologic difference between neonatally and late diagnosed CDH.